Full Text of HB2784 102nd General Assembly
HB2784enr 102ND GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 1. Short title. | 5 | | (a) This Act may be cited as the Community Emergency | 6 | | Services and Support Act. | 7 | | (b) This Act may be referred to as the Stephon Edward Watts | 8 | | Act. | 9 | | Section 5. Findings. The General Assembly recognizes that | 10 | | the Illinois Department of Human Services Division of Mental | 11 | | Health is preparing to provide mobile mental and behavioral | 12 | | health services to all Illinoisans as part of the federally | 13 | | mandated adoption of the 9-8-8 phone number. The General | 14 | | Assembly also recognizes that many cities and some states have | 15 | | successfully established mobile emergency mental and | 16 | | behavioral health services as part of their emergency response | 17 | | system to support people who need such support and do not | 18 | | present a threat of physical violence to the responders. In | 19 | | light of that experience, the General Assembly finds that in | 20 | | order to promote and protect the health, safety, and welfare | 21 | | of the public, it is necessary and in the public interest to | 22 | | provide emergency response, with or without medical | 23 | | transportation, to individuals requiring mental health or |
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| 1 | | behavioral health services in a manner that is substantially | 2 | | equivalent to the response already provided to individuals who | 3 | | require emergency physical health care. | 4 | | Section 10. Applicability; home rule. This Act applies to | 5 | | every unit of local government that provides or coordinates | 6 | | ambulance or similar emergency medical response or | 7 | | transportation services for individuals with emergency medical | 8 | | needs. A home rule unit may not respond to or provide services | 9 | | for a mental or behavioral health emergency, or create a | 10 | | transportation plan or other regulation, relating to the | 11 | | provision of mental or behavioral health services in a manner | 12 | | inconsistent with this Act. This Act is a limitation under | 13 | | subsection (i) of Section 6 of Article VII of the Illinois | 14 | | Constitution on the concurrent exercise by home rule units of | 15 | | powers and functions exercised by the State. | 16 | | Section 15. Definitions. As used in this Act: | 17 | | "Division of Mental Health" means the Division of Mental | 18 | | Health of the Department of Human Services. | 19 | | "Emergency" means an emergent circumstance caused by a | 20 | | health condition, regardless of whether it is perceived as | 21 | | physical, mental, or behavioral in nature, for which an | 22 | | individual may require prompt care, support, or assessment at | 23 | | the individual's location. | 24 | | "Mental or behavioral health" means any health condition |
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| 1 | | involving changes in thinking, emotion, or behavior, and that | 2 | | the medical community treats as distinct from physical health | 3 | | care. | 4 | | "Physical health" means a health condition that the | 5 | | medical community treats as distinct from mental or behavioral | 6 | | health care. | 7 | | "PSAP" means a Public Safety Answering Point | 8 | | tele-communicator. | 9 | | "Community services" and "community-based mental or | 10 | | behavioral health services" may include both public and | 11 | | private settings. | 12 | | "Treatment relationship" means an active association with | 13 | | a mental or behavioral care provider able to respond in an | 14 | | appropriate amount of time to requests for care. | 15 | | "Responder" is any person engaging with a member of the | 16 | | public to provide the mobile mental and behavioral service | 17 | | established in conjunction with the Division of Mental Health | 18 | | establishing the 9-8-8 emergency number. A responder is not an | 19 | | EMS Paramedic or EMT as defined in the Emergency Medical | 20 | | Services (EMS) Systems Act unless that responding agency has | 21 | | agreed to provide a specialized response in accordance with | 22 | | the Division of Mental Health's services offered through its | 23 | | 9-8-8 number and has met all the requirements to offer that | 24 | | service through that system.
| 25 | | Section 20. Coordination with Division of Mental Health. |
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| 1 | | Each 9-1-1 PSAP and provider of emergency services dispatched | 2 | | through a 9-1-1 system must coordinate with the mobile mental | 3 | | and behavioral health services established by the Division of | 4 | | Mental Health so that the following State goals and State | 5 | | prohibitions are met whenever a person interacts with one of | 6 | | these entities for the purpose seeking emergency mental and | 7 | | behavioral health care or when one of these entities | 8 | | recognizes the appropriateness of providing mobile mental or | 9 | | behavioral health care to an individual with whom they have | 10 | | engaged. The Division of Mental Health is also directed to | 11 | | provide guidance regarding whether and how these entities | 12 | | should coordinate with mobile mental and behavioral health | 13 | | services when responding to individuals who appear to be in a | 14 | | mental or behavioral health emergency while engaged in conduct | 15 | | alleged to constitute a non-violent misdemeanor. | 16 | | Section 25. State goals. | 17 | | (a) 9-1-1 PSAPs, emergency services dispatched through | 18 | | 9-1-1 PSAPs, and the mobile mental and behavioral health | 19 | | service established by the Division of Mental Health must | 20 | | coordinate their services so that the State goals listed in | 21 | | this Section are achieved. Appropriate mobile response service | 22 | | for mental and behavioral health emergencies shall be | 23 | | available regardless of whether the initial contact was with | 24 | | 9-8-8, 9-1-1 or directly with an emergency service dispatched | 25 | | through 9-1-1. Appropriate mobile response services must: |
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| 1 | | (1) ensure that individuals experiencing mental or | 2 | | behavioral health crises are diverted from hospitalization | 3 | | or incarceration whenever possible, and are instead linked | 4 | | with available appropriate community services;
| 5 | | (2) include the option of on-site care if that type of | 6 | | care is appropriate and does not override the care | 7 | | decisions of the individual receiving care. Providing care | 8 | | in the community, through methods like mobile crisis | 9 | | units, is encouraged. If effective care is provided on | 10 | | site, and if it is consistent with the care decisions of | 11 | | the individual receiving the care, further transportation | 12 | | to other medical providers is not required by this Act; | 13 | | (3) recommend appropriate referrals for available | 14 | | community services if the individual receiving on-site | 15 | | care is not already in a treatment relationship with a | 16 | | service provider or is unsatisfied with their current | 17 | | service providers. The referrals shall take into | 18 | | consideration waiting lists and copayments, which may | 19 | | present barriers to access; and
| 20 | | (4) subject to the care decisions of the individual | 21 | | receiving care, provide transportation for any individual | 22 | | experiencing a mental or behavioral health emergency. | 23 | | Transportation shall be to the most integrated and least | 24 | | restrictive setting appropriate in the community, such as | 25 | | to the individual's home or chosen location, community | 26 | | crisis respite centers, clinic settings, behavioral health |
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| 1 | | centers, or the offices of particular medical care | 2 | | providers with existing treatment relationships to the | 3 | | individual seeking care. | 4 | | (b) Prioritize requests for emergency assistance. 9-1-1 | 5 | | PSAPs, emergency services dispatched through 9-1-1 PSAPs, and | 6 | | the mobile mental and behavioral health service established by | 7 | | the Division of Mental Health must provide guidance for | 8 | | prioritizing calls for assistance and maximum response time in | 9 | | relation to the type of emergency reported. | 10 | | (c) Provide appropriate response times. From the time of | 11 | | first notification, 9-1-1 PSAPs, emergency services dispatched | 12 | | through 9-1-1 PSAPs, and the mobile mental and behavioral | 13 | | health service established by the Division of Mental Health | 14 | | must provide the response within response time appropriate to | 15 | | the care requirements of the individual with an emergency. | 16 | | (d) Require appropriate responder training. Responders | 17 | | must have adequate training to address the needs of | 18 | | individuals experiencing a mental or behavioral health | 19 | | emergency. Adequate training at least includes: | 20 | | (1) training in de-escalation techniques; | 21 | | (2) knowledge of local community services and | 22 | | supports; and
| 23 | | (3) training in respectful interaction with people | 24 | | experiencing mental or behavioral health crises, including | 25 | | the concepts of stigma and respectful language. | 26 | | (e) Require minimum team staffing. The Division of Mental |
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| 1 | | Health, in consultation with the Regional Advisory Committees | 2 | | created in Section 40, shall determine the appropriate | 3 | | credentials for the mental health providers responding to | 4 | | calls, including to what extent the responders must have | 5 | | certain credentials and licensing, and to what extent the | 6 | | responders can be peer support professionals. | 7 | | (f) Require training from individuals with lived | 8 | | experience. Training shall be provided by individuals with | 9 | | lived experience to the extent available. | 10 | | (g) Adopt guidelines directing referral to restrictive | 11 | | care settings. Responders must have guidelines to follow when | 12 | | considering whether to refer an individual to more restrictive | 13 | | forms of care, like emergency room or hospital settings. | 14 | | (h) Specify regional best practices. Responders providing | 15 | | these services must do so consistently with best practices, | 16 | | which include respecting the care choices of the individuals | 17 | | receiving assistance. Regional best practices may be broken | 18 | | down into sub-regions, as appropriate to reflect local | 19 | | resources and conditions. With the agreement of the impacted | 20 | | EMS Regions, providers of emergency response to physical | 21 | | emergencies may participate in another EMS Region for mental | 22 | | and behavioral response, if that participation shall provide a | 23 | | better service to individuals experiencing a mental or | 24 | | behavioral health emergency. | 25 | | (i) Adopt system for directing care in advance of an | 26 | | emergency. The Division of Mental Health shall select and |
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| 1 | | publicly identify a system that allows individuals who | 2 | | voluntarily chose to do so to provide confidential advanced | 3 | | care directions to individuals providing services under this | 4 | | Act. No system for providing advanced care direction may be | 5 | | implemented unless the Division of Mental Health approves it | 6 | | as confidential, available to individuals at all economic | 7 | | levels, and non-stigmatizing. The Division of Mental Health | 8 | | may defer this requirement for providing a system for advanced | 9 | | care direction if it determines that no existing systems can | 10 | | currently meet these requirements. | 11 | | (j) Train dispatching staff. The personnel staffing 9-1-1, | 12 | | 3-1-1, or other emergency response intake systems must be | 13 | | provided with adequate training to assess whether coordinating | 14 | | with 9-8-8 is appropriate. | 15 | | (k) Establish protocol for emergency responder | 16 | | coordination. The Division of Mental Health shall establish a | 17 | | protocol for responders, law enforcement, and fire and | 18 | | ambulance services to request assistance from each other, and | 19 | | train these groups on the protocol. | 20 | | (l) Integrate law enforcement. The Division of Mental | 21 | | Health shall provide for law enforcement to request responder | 22 | | assistance whenever law enforcement engages an individual | 23 | | appropriate for services under this Act. If law enforcement | 24 | | would typically request EMS assistance when it encounters an | 25 | | individual with a physical health emergency, law enforcement | 26 | | shall similarly dispatch mental or behavioral health personnel |
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| 1 | | or medical transportation when it encounters an individual in | 2 | | a mental or behavioral health emergency. | 3 | | Section 30. State prohibitions. 9-1-1 PSAPs, emergency | 4 | | services dispatched through 9-1-1 PSAPs, and the mobile mental | 5 | | and behavioral health service established by the Division of | 6 | | Mental Health must coordinate their services so that, based on | 7 | | the information provided to them, the following State | 8 | | prohibitions are avoided: | 9 | | (a) Law enforcement responsibility for providing mental | 10 | | and behavioral health care. In any area where responders are | 11 | | available for dispatch, law enforcement shall not be | 12 | | dispatched to respond to an individual requiring mental or | 13 | | behavioral health care unless that individual is (i) involved | 14 | | in a suspected violation of the criminal laws of this State, or | 15 | | (ii) presents a threat of physical injury to self or others. | 16 | | Responders are not considered available for dispatch under | 17 | | this Section if 9-8-8 reports that it cannot dispatch | 18 | | appropriate service within the maximum response times | 19 | | established by each Regional Advisory Committee under Section | 20 | | 45. | 21 | | (1) Standing on its own or in combination with each | 22 | | other, the fact that an individual is experiencing a | 23 | | mental or behavioral health emergency, or has a mental | 24 | | health, behavioral health, or other diagnosis, is not | 25 | | sufficient to justify an assessment that the individual is |
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| 1 | | a threat of physical injury to self or others, or requires | 2 | | a law enforcement response to a request for emergency | 3 | | response or medical transportation. | 4 | | (2) If, based on its assessment of the threat to | 5 | | public safety, law enforcement would not accompany medical | 6 | | transportation responding to a physical health emergency, | 7 | | unless requested by responders, law enforcement may not | 8 | | accompany emergency response or medical transportation | 9 | | personnel responding to a mental or behavioral health | 10 | | emergency that presents an equivalent level of threat to | 11 | | self or public safety. | 12 | | (3) Without regard to an assessment of threat to self | 13 | | or threat to public safety, law enforcement may station | 14 | | personnel so that they can rapidly respond to requests for | 15 | | assistance from responders if law enforcement does not | 16 | | interfere with the provision of emergency response or | 17 | | transportation services. To the extent practical, not | 18 | | interfering with services includes remaining sufficiently | 19 | | distant from or out of sight of the individual receiving | 20 | | care so that law enforcement presence is unlikely to | 21 | | escalate the emergency. | 22 | | (b) Responder involvement in involuntary commitment. In | 23 | | order to maintain the appropriate care relationship, | 24 | | responders shall not in any way assist in the involuntary | 25 | | commitment of an individual beyond (i) reporting to their | 26 | | dispatching entity or to law enforcement that they believe the |
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| 1 | | situation requires assistance the responders are not permitted | 2 | | to provide under this Section; (ii) providing witness | 3 | | statements; and (iii) fulfilling reporting requirements the | 4 | | responders may have under their professional ethical | 5 | | obligations or laws of this state. This prohibition shall not | 6 | | interfere with any responder's ability to provide physical or | 7 | | mental health care. | 8 | | (c) Use of law enforcement for transportation. In any area | 9 | | where responders are available for dispatch, unless requested | 10 | | by responders, law enforcement shall not be used to provide | 11 | | transportation to access mental or behavioral health care, or | 12 | | travel between mental or behavioral health care providers, | 13 | | except where no alternative is available. | 14 | | (d) Reduction of educational institution obligations. The | 15 | | services coordinated under this Act may not be used to replace | 16 | | any service an educational institution is required to provide | 17 | | to a student. It shall not substitute for appropriate special | 18 | | education and related services that schools are required to | 19 | | provide by any law. | 20 | | Section 35. Non-violent misdemeanors. The Division of | 21 | | Mental Health's Guidance for 9-1-1 PSAPs and emergency | 22 | | services dispatched through 9-1-1 PSAPs for coordinating the | 23 | | response to individuals who appear to be in a mental or | 24 | | behavioral health emergency while engaging in conduct alleged | 25 | | to constitute a non-violent misdemeanor shall promote the |
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| 1 | | following: | 2 | | (a) Prioritization of Health Care. To the greatest | 3 | | extent practicable, community-based mental or behavioral | 4 | | health services should be provided before addressing law | 5 | | enforcement objectives. | 6 | | (b) Diversion from Further Criminal Justice | 7 | | Involvement. To the greatest extent practicable, | 8 | | individuals should be referred to health care services | 9 | | with the potential to reduce the likelihood of further law | 10 | | enforcement engagement. | 11 | | Section 40. Statewide Advisory Committee. | 12 | | (a) The Division of Mental Health shall establish a | 13 | | Statewide Advisory Committee to review and make | 14 | | recommendations for aspects of coordinating 9-1-1 and the | 15 | | 9-8-8 mobile mental health response system most appropriately | 16 | | addressed on a State level. | 17 | | (b) Issues to be addressed by the Statewide Advisory | 18 | | Committee include, but are not limited to, addressing changes | 19 | | necessary in 9-1-1 call taking protocols and scripts used in | 20 | | 9-1-1 PSAPs where those protocols and scripts are based on or | 21 | | otherwise dependent on national providers for their operation.
| 22 | | (c) The Statewide Advisory Committee shall recommend a | 23 | | system for gathering data related to the coordination of the | 24 | | 9-1-1 and 9-8-8 systems for purposes of allowing the parties | 25 | | to make ongoing improvements in that system. As practical, the |
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| 1 | | system shall attempt to determine issues including, but not | 2 | | limited to: | 3 | | (1) the volume of calls coordinated between 9-1-1 and | 4 | | 9-8-8; | 5 | | (2) the volume of referrals from other first | 6 | | responders to 9-8-8; | 7 | | (3) the volume and type of calls deemed appropriate | 8 | | for referral to 9-8-8 but could not be served by 9-8-8 | 9 | | because of capacity restrictions or other reasons; | 10 | | (4) the appropriate information to improve | 11 | | coordination between 9-1-1 and 9-8-8; and | 12 | | (5) the appropriate information to improve the 9-8-8 | 13 | | system, if the information is most appropriately gathered | 14 | | at the 9-1-1 PSAPs. | 15 | | (d) The Statewide Advisory Committee shall consist of: | 16 | | (1) the Statewide 9-1-1 Administrator, ex officio; | 17 | | (2) one representative designated by the Illinois | 18 | | Chapter of National Emergency Number Association (NENA); | 19 | | (3) one representative designated by the Illinois | 20 | | Chapter of Association of Public Safety Communications | 21 | | Officials (APCO); | 22 | | (4) one representative of the Division of Mental | 23 | | Health; | 24 | | (5) one representative of the Illinois Department of | 25 | | Public Health; | 26 | | (6) one representative of a statewide organization of |
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| 1 | | EMS responders; | 2 | | (7) one representative of a statewide organization of | 3 | | fire chiefs; | 4 | | (8) two representatives of statewide organizations of | 5 | | law enforcement; | 6 | | (9) two representatives of mental health, behavioral | 7 | | health, or substance abuse providers; and | 8 | | (10) four representatives of advocacy organizations | 9 | | either led by or consisting primarily of individuals with | 10 | | intellectual or developmental disabilities, individuals | 11 | | with behavioral disabilities, or individuals with lived | 12 | | experience. | 13 | | (e) The members of the Statewide Advisory Committee, other | 14 | | than the Statewide 9-1-1 Administrator, shall be appointed by | 15 | | the Secretary of Human Services. | 16 | | Section 45. Regional Advisory Committees. | 17 | | (a) The Division of Mental Health shall establish Regional | 18 | | Advisory Committees in each EMS Region to advise on regional | 19 | | issues related to emergency response systems for mental and | 20 | | behavioral health. The Secretary of Human Services shall | 21 | | appoint the members of the Regional Advisory Committees. Each | 22 | | Regional Advisory Committee shall consist of: | 23 | | (1) representatives of the 9-1-1 PSAPs in the region; | 24 | | (2) representatives of the EMS Medical Directors | 25 | | Committee, as constituted under the Emergency Medical |
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| 1 | | Services (EMS) Systems Act, or other similar committee | 2 | | serving the medical needs of the jurisdiction; | 3 | | (3) representatives of law enforcement officials with | 4 | | jurisdiction in the Emergency Medical Services (EMS) | 5 | | Regions; | 6 | | (4) representatives of both the EMS providers and the | 7 | | unions representing EMS or emergency mental and behavioral | 8 | | health responders, or both; and | 9 | | (5) advocates from the mental health, behavioral | 10 | | health, intellectual disability, and developmental | 11 | | disability communities. | 12 | | (b) The majority of advocates on the Emergency Response | 13 | | Equity Committee must either be individuals with a lived | 14 | | experience of a condition commonly regarded as a mental health | 15 | | or behavioral health disability, developmental disability, or | 16 | | intellectual disability, or be from organizations primarily | 17 | | composed of such individuals. The members of the Committee | 18 | | shall also reflect the racial demographics of the jurisdiction | 19 | | served. | 20 | | (c) Subject to the oversight of the Department of Human | 21 | | Services Division of Mental Health, the EMS Medical Directors | 22 | | Committee is responsible for convening the meetings of the | 23 | | committee. Impacted units of local government may also have | 24 | | representatives on the committee subject to approval by the | 25 | | Division of Mental Health, if this participation is structured | 26 | | in such a way that it does not give undue weight to any of the |
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| 1 | | groups represented. | 2 | | Section 50. Regional Advisory Committee responsibilities. | 3 | | Each Regional Advisory Committee is responsible for designing | 4 | | the local protocol to allow its region's 9-1-1 call center and | 5 | | emergency responders to coordinate their activities with 9-8-8 | 6 | | as required by this Act and monitoring current operation to | 7 | | advise on ongoing adjustments to the local protocol. Included | 8 | | in this responsibility, each Regional Advisory Committee must: | 9 | | (1) negotiate the appropriate amendment of each 9-1-1 | 10 | | PSAP emergency dispatch protocols, in consultation with | 11 | | each 9-1-1 PSAP in the EMS Region and consistent with | 12 | | national certification requirements; | 13 | | (2) set maximum response times for 9-8-8 to provide | 14 | | service when an in-person response is required, based on | 15 | | type of mental or behavioral health emergency, which, if | 16 | | exceeded, constitute grounds for sending other emergency | 17 | | responders through the 9-1-1 system; | 18 | | (3) report, geographically by police district if | 19 | | practical, the data collected through the direction | 20 | | provided by the Statewide Advisory Committee in | 21 | | aggregated, non-individualized monthly reports. These | 22 | | reports shall be available to the Regional Advisory | 23 | | Committee members, the Department of Human Service | 24 | | Division of Mental Health, the Administrator of the 9-1-1 | 25 | | Authority, and to the public upon request; and |
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| 1 | | (4) convene, after the initial regional policies are | 2 | | established, at least every 2 years to consider amendment | 3 | | of the regional policies, if any, and also convene | 4 | | whenever a member of the Committee requests that the | 5 | | Committee consider an amendment. | 6 | | Section 55. Immunity. The exemptions from civil liability | 7 | | in Section 15.1 of the Emergency Telephone Systems Act apply | 8 | | to any act or omission in the development, design, | 9 | | installation, operation, maintenance, performance, or | 10 | | provision of service directed by this Act. | 11 | | Section 60. Scope. This Act applies to persons of all | 12 | | ages, both children and adults. This Act does not limit an | 13 | | individual's right to control his or her own medical care. No | 14 | | provision of this Act shall be interpreted in such a way as to | 15 | | limit an individual's right to choose his or her preferred | 16 | | course of care or to reject care. No provision of this Act | 17 | | shall be interpreted to promote or provide justification for | 18 | | the use of restraints when providing mental or behavioral | 19 | | health care. | 20 | | Section 65. PSAP and emergency service dispatched through | 21 | | a 9-1-1 PSAP; coordination of activities with mobile and | 22 | | behavioral health services. Each 9-1-1 PSAP and emergency | 23 | | service dispatched through a 9-1-1 PSAP must begin |
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| 1 | | coordinating its activities with the mobile mental and | 2 | | behavioral health services established by the Division of | 3 | | Mental Health once all 3 of the following conditions are met, | 4 | | but not later than January 1, 2023: | 5 | | (1) the Statewide Committee has negotiated useful | 6 | | protocol and 9-1-1 operator script adjustments with the | 7 | | contracted services providing these tools to 9-1-1 PSAPs | 8 | | operating in Illinois; | 9 | | (2) the appropriate Regional Advisory Committee has | 10 | | completed design of the specific 9-1-1 PSAP's process for | 11 | | coordinating activities with the mobile mental and | 12 | | behavioral health service; and | 13 | | (3) the mobile mental and behavioral health service is | 14 | | available in their jurisdiction. |
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